| NPI | 1811904873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CA G39414) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NH 17407) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NM 2004-0348) | |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2020-09-03 |